Management of Multiple Burned Patients with Inhalation Injuries

The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center. Patient C was transported by an emergency medical helicopter (doctor helicopter), and patient D was transported to our hospital by ambulance P. After tracheal intubation, both patients (C and D) required intensive care and mechanical ventilation. Patient A at hospital X was also intubated and transported to another hospital by the doctor helicopter. Fortunately, all patients survived. After a review among the parties involved in the incident, initiating an early request for additional human resources, vehicles, and medical support was recognized as contributing a key role in achieving a successful outcome.